The purpose of the Comparison of Asthma Programs for Schools (CAPS) study is to evaluate efficacy of a new developmentally-appropriate, school-based academic and counseling asthma health education program compared to a low-dose control, well-established, non-academic program. The new program for diverse fifth- grade students with asthma and their family caregivers is entitled, "Staying Healthy Asthma Responsible &Prepared" (SHARP). SHARP is a comprehensive, theory-driven, evidenced-guided program developed in collaboration with school personnel and members of one community asthma coalition that has two components: (a) a Student Component and (b) Community Component. The low-dose comparison group will receive Open Airways for Schools (OAS) that is widely disseminated through the American Lung Association. Specific Aim 1: Evaluate the efficacy of SHARP compared to the low-dose OAS control group for fifth-grade students on cognitive, psychosocial, and behavioral aspects of asthma management immediately post- and at 12 and 24 months post-intervention. Specific Aim 2: Evaluate the long-term effect of SHARP compared to the low-dose OAS control group for fifth-grade students on condition characteristics, use of healthcare services, and quality of life at 12 and 24 months post intervention. A two-group, longitudinal, prospective, cluster- randomized, single-blinded trial will be used. Schools will be matched based on fifth-grade enrollment numbers, standardized reading and math scores, free/reduced lunch eligibility, and racial/ethnic proportions prior to randomization. The unit of analysis will be the student. The sample will consist of 2 cohorts of fifth- grade students, ages 9-12 years, with asthma and their caregivers. Two cohorts of student/caregiver dyads will be recruited over 2 years (N=152 dyads per year for a total of 304 dyads over two years) and analyzed separately. A minimum of 5-6 dyads will be recruited from 30 elementary schools located in three communities with 10 schools selected from each community. Participants will represent varying socioeconomic, cultural, racial, and ethnic backgrounds. Recently retired certified elementary schoolteachers identified by the areas'school districts will be trained to serve as interveners to deliver SHARP or OAS during school hours. Evaluators will collect pre- and post-intervention data from dyads in the home using audio-linked data entry systems loaded on laptop computers at four time points. A bi-monthly automated voice recorded telephone survey will be placed to caregivers to monitor symptom days, medication use, use of healthcare services, and school absenteeism. To adjust for non-independence of observations within schools, hypotheses will be tested using the generalized estimating equations approach for categorical or ordinal variables and linear mixed models for continuous outcomes. After efficacy is demonstrated, this study would advance scientific knowledge through the offering of a comprehensive, developmentally-appropriate, school-based academic and counseling education program for older school age students with asthma that is not currently available. PUBLIC HEALTH RELEVANCE: Nine million U.S. children under 18 years of age have been diagnosed with asthma at some point in their lives and approximately 4 million children have had an asthma episode in the last 12 months. This project seeks to compare efficacy of two school-based asthma education programs for fifth-grade students with asthma aimed at improving cognitive, behavioral, and psychosocial outcomes;decreasing severity of illness;and improving quality of life. After efficacy is demonstrated, this study would advance scientific knowledge through the offering of a comprehensive, developmentally-appropriate, school-based academic and counseling education program for older school age students with asthma that is not currently available.